G.O.Ms.No.160, New Health Insurance Scheme, 2021 (go160)
The Government of Tamil Nadu Finance (Salaries) Department issued G.O.Ms.No.160 on 29 June 2021 to implement the New Health Insurance Scheme, 2021 through the United India Insurance Company Limited, Chennai. It provides health care assistance to covered employees and eligible family members from 1 July 2021 to 30 June 2025, and does not govern land, planning or property matters.
What the document does
G.O.Ms.No.160 of the Government of Tamil Nadu Finance (Salaries) Department implements the New Health Insurance Scheme, 2021. The scheme is administered by the Commissioner of Treasuries and Accounts and operated through the United India Insurance Company Limited, Chennai.
The scheme covers employees of Government departments, State Public Sector Undertakings, Statutory Boards, Local Bodies and State Government Universities, along with eligible family members. Eligible organisations and institutions registered under the Tamil Nadu Registration of Societies Act, 1975 may also enrol if they can bear the applicable Goods and Services Tax without liability falling on the State Budget.
Benefits and treatment limits
G.O.Ms.No.160 provides the following benefits for the four year block from 1 July 2021 to 30 June 2025:
- Cashless assistance of up to Rs.5 lakh for approved treatments and surgeries at approved hospitals.
- Assistance of up to Rs.10 lakh for specified illnesses.
- A standard overall family limit of Rs.10 lakh for the four year block.
- A limit of Rs.30,000 per eye for cataract surgery.
- A limit of Rs.50,000 for hysterectomy.
- Coverage for 203 approved treatments and surgeries through 1,169 empanelled hospitals.
- Reimbursement for non-emergency treatment at a non-network hospital, restricted to 75 per cent of the package rate for a similar procedure in the lowest grade network hospital.
A separate corpus fund may meet higher expenses for rare illnesses and exceptional circumstances, extending total benefit up to Rs.20 lakh where approved by the High Level Committee.
Enrolment, family coverage and contributions
G.O.Ms.No.160 makes enrolment compulsory for covered employees, even where an employee's spouse is a Central Government employee covered by the Central Government Health Insurance Scheme.
- The Government pays an annual premium of Rs.3,240 per employee, plus applicable Goods and Services Tax.
- Rs.300 is deducted monthly from salary, consisting of Rs.295 for the insurance subscription and Rs.5 for the corpus fund.
- Where both spouses are State Government employees, contribution is recovered only from the younger spouse.
- Parents are covered for an unmarried employee until marriage, and for a divorced employee without children until remarriage.
Who is excluded
G.O.Ms.No.160 excludes employees appointed on consolidated pay, fixed pay, honorarium, daily wages, contract, re-employment, specified temporary appointments or outsourcing. The document concerns employee health insurance and contains no provisions affecting land ownership, development approval or property transactions.
This summary is generated from the source document to help you find what is relevant. The PDF above is authoritative. For advice on your own property, use LandLens One or speak to a qualified professional.
Common questions
Does G.O.Ms.No.160 affect my land or CMDA planning approval?
No. G.O.Ms.No.160 concerns the New Health Insurance Scheme, 2021 for covered employees and eligible family members. The source contains no land, planning or property provisions.
How much medical assistance is available under the scheme?
The scheme provides up to Rs.5 lakh for approved treatments and up to Rs.10 lakh for specified illnesses during the four year block. Rare illness and exceptional cases may receive total benefit up to Rs.20 lakh if approved by the High Level Committee.
Can treatment at a non-network hospital be reimbursed?
Yes, non-emergency treatment at a non-network hospital may be reimbursed. Reimbursement is limited to 75 per cent of the package rate for a similar procedure in the lowest grade network hospital.
Are contract and outsourced employees covered?
No. The exclusions include employees appointed on contract, outsourcing, daily wages, consolidated pay, fixed pay, honorarium, re-employment and specified temporary arrangements.
